Chondroitin should have resulted in more accurate estimates of total costs than assigning overall

Chondroitin there were limited data available. However, it was possible to stratify stroke outcomes by patient level data, and thereby, assign different cost estimates for different disability levels. This should have resulted in more accurate estimates of total costs than assigning overall stroke follow up costs.31 This model and evaluation offer a number of strengths. Foremost is the use of clinical parameters estimated directly from individual patient level data in the RE LY study. Second, the main comparator, warfarin as studied in the RE LY trial, can be considered as conservative because the INR chemical library screening control observed in routine UK practice is likely to be inferior in comparison. Third, the model allowed the approved stratification of the two dabigatran doses to be reflected in the correct populations. Fourth, it provided the flexibility to investigate the cost effectiveness of dabigatran compared with other treatment strategies provided to UK patients.
Finally, the model has been populated with UK relevant data, and the stroke risk profiles of the patient populations are representative of those that would be expected drug library in UK patients. CONCLUSION In conclusion, treatment with dabigatran reduced the risk of stroke and intracranial haemorrhage compared with warfarin, aspirin and those patients remaining untreated. These clinical benefits offset a substantial portion of the additional drug cost associated with dabigatran, yielding favourable cost effectiveness ratios well below standard WTP thresholds. Overall, this economic evaluation supports the use of dabigatran as a costeffective first line treatment for the prevention of stroke and SE in eligible UK patients with AF.Atrial fibrillation has long been shown to increase the risk of stroke and death.5,6 Pharmacological stroke prevention agents for nonvalvular atrial fibrillation have evolved in an effort to address various aspects of the coagulation cascade. Specific efforts aimed at nilotinib altering thrombus formation have included platelet function inhibitors, such as aspirin and clopidogrel, and vitamin K blockade, with warfarin.
Treatment with warfarin results in a relative stroke risk reduction of 60%,6 however, this drug’s efficacy has been hindered by the need for frequent monitoring, multiple interactions with food and other medications, and its increased risk of hemorrhage. 1 Newer agents have aimed at more direct coagulation factor inhibition. Large, randomized, multicenter noninferiority trials have shown that direct thrombin inhibitors, such as dabigatran, have lower rates of stroke and systemic embolism than warfarin with decreased rates of major hemorrhage.1,3 In the event of traumatic hemorrhage in patients receiving dabigatran, however, there are currently no effective reversal agents. Familiarity with this new anticoagulation agent is critical in the neurosurgical community so that management options, while currently limited, can be implemented in a timely fashion. Case Report This 83 year old man was evaluated in the emergency department after a ground level fall at home. One month earlier, he had been diagnosed with new onset atrial fibrillation and started on dabigatran 150 mg twice a day by his primary care physician. On initial neurosurgical evaluation.

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